Cardiac Structure and Function in Women After Preeclampsia: A Systematic Review and Meta-Analysis
Authors' conclusion
Preeclampsia is associated with subclinical myocardial dysfunction, characterized by impaired GLS and increased LVMI. Persistent impairment in GLS was observed up to 10 years postpartum, whereas the association with elevated LVMI beyond 6 months postpartum should be interpreted with caution. Further studies are required to assess when subclinical myocardial dysfunction progresses to symptomatic clinical HF.
Study context
- Population
- Women with a history of preeclampsia assessed by transthoracic echocardiographywomen in 45 case-control studies, including 2,288 women with a history of preeclampsia · women with a history of preeclampsia 2,288
- Participants
- 8,991 women
- Comparison
- Women with preeclampsia vs normotensive controls
- Preeclampsian = 2,288
- Outcome
- Echocardiographic measures during pregnancy
- Follow-up
- During pregnancy
Methodological detailsPreferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 45 case-control studies
- Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines
- 45 case-control studies
Pooled result
As reported in the abstract
preeclampsia vs normotensive controlsStandard mean difference (95% CI)
LVMI, higher with preeclampsia
10.85(6.30–15.39)
- Relative wall thickness, higher with preeclampsia
- 0.05 (95% CI 0.03–0.08)
- E/e', higher with preeclampsia
- 1.58 (95% CI 1.02–2.13)
- Isovolumetric relaxation time, higher with preeclampsia
- 8.74 (95% CI 3.14–14.34)
- E/A ratio, lower with preeclampsia
- −0.27 (95% CI −0.51 to −0.04)
- Absolute global longitudinal strain (GLS) values, reduced with preeclampsia
- 2.27 (95% CI 0.43–4.11)
Further pooled results
GLS and left ventricular mass index (LVMI) postpartum · out to 10 years postpartum
- GLS remained reduced, and LVMI remained elevated in women with a history of preeclampsia; difference persisted out to 10 years postpartum
- Evidence for persistent LVMI elevation >6 months postpartum was not robust in sensitivity analyses excluding overlapping cohorts
All other variables · >6 months postpartum
- No significant difference
Left ventricular ejection fraction and right ventricular function · throughout
- Remained similar in the preeclampsia and control groups
Original publication
Cardiac Structure and Function in Women After Preeclampsia: A Systematic Review and Meta-Analysis. JACC Heart Fail. Published 22 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it